♪ Bob and Brad, ♪
♪ the two most famous physical therapists ♪
♪ on the internet ♪
- Hi folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the most famous physical therapists on the internet.
- In our opinion, of course, Bob.
- Today, my friends we're going to show you
how to heal Golfer's elbow with self massage.
So, golfer's elbow is a medical,
the medical term for it is medial epicondylitis.
- Right there.
- That sounds really fancy, doesn't it?
- Right.
- So you have, if you look at the elbow,
we've got the bump here,
we've got a bump here, and you've got a bump here.
This is the inside bump.
- That's what the medial, medial means that.
Epicondyl is the name of that bone.
Itis means inflammation.
There you go.
- There you go. Real easy.
So to that bone, coming to the bone,
is a tendon which attaches a bunch of ...
Oh, I'm sorry. Wrong way.
A bunch of these forearm muscles attached
to this bone through a heavy tendon here.
Now when these muscles are being overused, like in golf,
which is never possible to play too much golf.
(Brad laughs)
But if they're being overused, they can start
to develop maybe minor tears
and inflammation in that tendon.
And it gets to the point where it really hurts.
- Yeah.
- And you can't do anything.
Now, just had tennis elbow, right?
- Yeah. I've had this too, but not near so bad.
- Sure.
- I don't golf.
You know, you can get it from a lot of different activities.
- Any, like with tennis elbow
it's more extension activities,
and with golf, it's more flection activities.
- Sure. Right.
- So it can be very tender.
You know, we, the approach that we take is that
there's some scar tissue in there that is trying to heal.
So we want to get more blood flow to the area
and we may even try to realign those fibers,
according to James Cyriax,
the father of orthopedic medicine.
So this is the technique he came up with.
So we're going to do cross fiber friction massage.
You can take your fingers and put one by the other
or you can put one on top of the other
and you're going to go right and find that tender spot,
usually off the bone a little bit,
and going right over the tendon.
- And you'll know if you get on the really tender spot,
this is going to hurt like the Dickens.
So you need to get away from it.
- Get away from it a little bit
- And go this direction more towards, more on the muscle.
- Now Brad's using his thumb there,
which should work for the angle.
You can also use the fingers.
Now you're going to really dig
in fairly deep and the fibers run this way.
So you're going to go across the fiber.
That's why it's called a cross fiber friction massage.
Applying some friction there.
So you start massaging and if after
30 seconds to 60 seconds, it's just too tender,
it just keeps getting worse and worse and worse,
in that case, I'm going to have you try massage number two
and I'll show that to you in a minute.
- Okay.
- But let's say it starts to plateau the pain
and it maybe even gets a little bit better.
Then you can continue for up to 15 minutes.
Now we recommend because that's such a long time
that maybe you want to split it
up to three times a day for five minutes.
- Your fingers or your thumb will wear out.
- Right.
- Either that, or you're going to get some kind of itis-
- In the hand.
- Yeah, you're going to have really sore fingers.
- And we'll show you an alternative for that.
Brad, why don't you show that right now?
- Oh, sure.
- You could use a massage gun.
- Yup.
So let's take, well, this one
cause you have, a round head actually works good.
You know, there's different types of heads.
- Yeah. I don't know if you can see those.
Oh, that was good.
- Black on black.
They're, they come in the kit with the massage gun.
So we'll get this moving here.
And you need, when you get a gun
they reciprocate or they travel, percuss, in one direction.
You're not going to go into it this way.
That is just gonna make it really inflamed
and sore and be painful.
So you turn the gun sideways
and you may want to start more on the muscle belly
and you work your way closer to the area.
And you know, you can have a little pain with it, but
like Bob said, you know, after 30 seconds or a little more
it should plateau or even start to feel better.
And then you can move a little closer.
So you got to find that happy medium.
But if it's just too painful
and it hurts and it's getting worse,
then you got to back up and get into the muscle.
- Yeah, get into the muscle belly, work the belly and see
if you can loosen up that belly.
I'm going to show you one other thing
you can do on the tendon, too.
But that would definitely be something you can do.
And that you can go directly into, right, Brad?
- Yep, then you can work at.
And the idea is if you get the tightness
out of the muscle belly, it'll take stress
off where the injury is.
- It won't pull as hard on that area.
- Yep, yep.
- So the other thing you can try is
if it's just really tender over the tendon,
you can actually put your thumb right on it.
This is the McKenzie technique, Robin McKenzie,
just put your thumb on it and squeeze it a little bit
and then you're going to bend the wrist.
Do this just 10 times.
- So with your thumb, you can feel the muscles contract.
- You can feel the tendon. I'm right on the tendon.
And this is just to start
preparing the tendon for some pressure.
- And a lot of times that pressure,
it'll actually feel good.
- Right.
You know, if it's not too tender, depending, you know,
you just adjust the position.
So in essence, you know,
the fallback position is you work on the muscle belly.
- Sure. Yep.
- And you can always, almost always do that.
And that'll again, take more pressure off the tendon itself.
- And the massage gun will save your hands
and maybe save your marriage if your spouse needs it done.
- You could actually and use the balls
on that if you didn't have a gun or whatever.
- Yeah, you could roll your forearm on there
or you could roll the ball on the forearm.
- Yep.
- So you can't do cross fiber with these though.
- No.
- That really wouldn't work
- But it does get in and it gives some relief.
- Right, I'm going to show a little bit
of a little bonus here.
Just some forearm stretches you can do
to help sometimes with a forearm problem.
Now you can first tell whether or not your forearm
is tight with pronation, supination,
by you first put your hands palm up
and if you put a ruler across your wrist,
they should be nearly level.
Now the other way, the same thing.
They should be nearly level.
If you find one that's like this
and the other one's all the way down,
this one needs a lot of stretching.
So what'd you going to do is you're going
to bring it up and you can stretch it this way,
with the palm away from you,
and you can stretch it palm toward you.
- So the elbow's bent all the way.
- Elbow's bent. You're into your side.
- Yep. Right there.
- You're stretching it palm out.
You're stretching and palm in.
- So you're not grabbing the hand.
You're grabbing the wrist and try
to get a good hold of that.
- So I'll show you on the left side now
I'm going to grab the wrist.
I'm going to take it palm out and then take it palm in.
- So we've got flat here and still there.
Yep, and if you're lacking motion,
that elbow and the tendon need to take up the extra motion
and they're going to work harder.
- Sure.
It's just as simple as physics, I guess it would be.
- Yep. Physics, mechanics.
- Biomechanics.
- There you go.
- So, all right. Thanks for watching.
- That's it?
- Yeah, that's it.
- Oh, excellent.
Well what about, are we gonna-
- Oh, we'll do it on the next one.
- Okay. It's a surprise.
(relaxed music)